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Nursing home
in study makes strides with pain
By Kevin Simpson,
Denver Post Staff Writer
Friday, November 08, 2002 - Of course the nurses could "feel" the residents' pain
- and help them manage it - at the Westminster nursing home.
But when the receptionist,
the housekeeper and virtually every other employee at the Clear Creek Care Center
learned to recognize the often unspoken signs of distress, everyone felt better.
That includes administrator
Beth Irtz, whose participation in a pilot program to improve the quality of nursing
homes - and publish the findings - has paid off with a huge reduction in reports
of moderate to very bad pain.
Her story, and
others in the six-state trial study, have prompted the federal Centers for Medicare
and Medicaid Services to take the initiative nationwide.
"We developed a
mission statement around pain management, posted it, went over it at staff meetings,"
Irtz said. "We started introducing it in orientation. And by doing that, even
the housekeeper and receptionist could go to a nurse and say a resident is having
pain - things that hadn't happened before."
The pilot program
began in April to standardize quality measurements surrounding nursing home issues
like pain, bed sores and delirium; make the results available to consumers; and
offer technical support for participating facilities in Colorado, Maryland, Ohio,
Rhode Island, Florida and Washington.
While a key component
of the program is to help consumers make more informed choices in selecting nursing
homes, the initiative doesn't claim to be a watchdog or weed out substandard facilities.
Results of the study's findings can be found on the website www.medicare.gov
under the heading "Nursing Home Compare," or by calling 1-800-MEDICARE.
But project workers
said making the results easily accessible to consumers remains a challenge.
"The information
is complex, and you have to be motivated to get through it," said Erich Kirshner,
spokesman for the Colorado Foundation for Medical Care, the state's quality improvement
organization. "It's been less challenging to get the attention of the industry
- they were pretty much on board from the beginning."
Working through
state quality improvement organizations, the program quantified nursing home performance
in 10 specific areas and helped foster improvement. About 50 Colorado facilities
- far more than project organizers anticipated - participated in support measures
that focused on pain management.
"We're really working
at getting systems in place at facilities," said Colorado project director Laura
Palmer, "so it's not something that occurs overnight. They're working from the
ground level up, making sure they're up to date with current guidelines. We want
to make it sustainable."
Participation in
the six pilot states has been so strong, said David Schulke, executive vice president
of the American Health Quality Association, that budget issues already have emerged.
If funding doesn't
expand to meet demand for support, Schulke said, "cynicism can set in."
"Now, everybody's
very pleased, and hoping we can fulfill our end of the bargain," he said. "When
nursing homes commit, we want our answer to be yes. It's a good problem to have
in a way, but we don't want providers to get the impression that we're going to
gin up interest and not follow through."
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